Surgical wound are caused due to the surgical

incision in any part of the body. surgical

wound ‘s edges are usually clean and occur
under aseptic conditions.
According to TNAI
 -It is a sterile protective surgical covering,
applied to a wound /incision with aseptic
technique, with or without medication.

According to Annamma Jacob

 Cleansing a wound or incision and applying
sterile protective covering using aseptic
technique.
 To promote wound healing.
 To prevent micro organism from entering the
wound.
 To decrease the presence of purulent wound
drainage.
 To absorb fluid and apply medication .
 To immobilize and support the wound.
 To assist in removal of necrotic tissue.
 To apply medication to the wound
 To provide comfort.
 To support or splint the wound site.
 Sterile dressing tray containing
 Artery forceps-1
 Thumb forceps-1
 Cotton swabs.
 Gauze pieces.
 Surgical pads
 Kidney tray-1
 Sterile scissor-1
 Suture cutting scissor-1
 Small bowl-1
 Dressing towels
 A clean tray containing
 Sterile gloves
 Normal saline
 Ordered medication
 Adhesive plaster
 Bandage scissors
 Plastic bag
 Mackintosh
 Culture tube(optional)
 Maintain a strict aseptic technique to prevent cross
infection ,to and from the wound .all materials
touching the wound should be sterile.
 All articles should be disinfected thoroughly.
 Wash hands thoroughly before and after the
procedure.
 One set of instruments should be used for one
dressing.
 Use masks,sterile gloves and gown to minimise
wound contamination.
 Dressing should not be done immediately after
sweeping and dusting wait atleast for 15-20 mins.
 Use individually wrapped sterile dressing and
equipment for the wound.
 Maintain a sterile field around the wound by spreading
sterile towels.
 Avoid talking coughing sneezing once the area is
opened.
 If the dressing is adherent to the wound due to dry
secreations or blood wet it with sterile saline before it is
removed.
 Observe the discharge from the wound accurately for
colour odour amount and consistency
 Avoid meal timings for doing dressings .it should be
done either half an hour before or after the meal.
 Identify the patient and position him comfortably.
 Explain the procedure and provide privacy
 Drape the patient.
 Close the doors and windows. put off the fan to
prevent draughts.
 Keep one assistant for dressing of the large wounds.
 Protect the bed with a mackintosh and a treatment
towel.
 Expose the part as necessary.
 Untie the bandage or adhesive and remove only after
hand washing.
 Turn the patient’s head to one side to prevent anxiety.
 Remove the mackintosh and treatment towel.
 Take all articles to the treatment room
 Discard the soiled dressing in the covered container and send it
for incineration.
 Remove the instruments and other articles from the infectant
solution and clean them thoroughly.
 Dry them and reset the tray and send it for autoclaving.
 Replace all articles at the proper place.
 Help the patient to dress up and make him comfortable.
 Replace the bed linen.
 Wash hands.
 Record the procedure in nurses record ,condition of wound type
and amount of discharge ,condition of the suture etc.if any
abnormality is found report to the surgeon keep the unit tidy and
clean
 ANATOMY AND PHYSIOLOGY
 Superficial wounds pierce only the skin.deeper wound
involve connective tissue ,fascia ,muscles,blood vessels
and nerves.
 Nerves are close to the surface ,so superficial wounds
are very painful.
 The skin is richly supplied with blood and blood
supply is essential for healing.
 Healing is rapid if there is no infection in the wound.
 Healing is rapid if there is no infection in the wound.
 Healing is faster in the young and more slowly in aged.
 Healing is slow due to dehydration,hypoproteinemia
and deficiency of vitamin c
 MICROBIOLOGY
 Wash hands thouroughly before and after the
procedure to avoid cross infection
 Maintain aseptic technique during dressing.
 Anything that touches a wound should be sterile .the
dressing ,instruments ,solutions etc.
 All dressing material,instruments,should be sterilized
by autoclaving.
 Never touch the wound itself ,the skin surrounding the
wound or the inner dressing to avoid infection.
 Disinfect the contaminated articles before reuse.
 Collect soiled dressings and burn it to prevent spread
of infection.
 Use gloves ,gown,mask for dressing.
 Keep all the sterile articles covered until it is time for use.
 As bacteria travel along with the dust particles, avoid
flapping of the bed cloths and dresses to prevent dust
particles entering the wound.
 Open wound provide a ready culture medium for bacteria
so open wounds must be sealed as early as possible.
 The skin is cleaned as well as possible around the wound
with alcohol to prevent the bacteria on the skin from
infecting the wound.
 Contaminated dressing must be destroyed by burning.
 Maintain resistance of the patient by giving adequate diet
rich in proteins vit B and C.
 PHYSICS AND CHEMISTRY
 Gauze absorbs drainage by capillary attraction and keeps
the wound dry.
 Fluids move downwards asa a result of gravitational pull so
drainage tubes are put at the lower edge of the wound.
 Alcohol is most efficient in a 70% solution because its action
is slow and diffuses throughout the entire bacterium before
proteins coagulate .when coagulation occurs the diffusion is
complete and the organism is dead.
 A solution greater than 80% hardens the bacteria and does
not penetrate them therefore not killing them
 Strong chemical destroy tissues as well as micro organisms
and healing is destroyed.
 PHARMACOLOGY
 Spirit ,iodine ,dettol etc are used as skin antiseptics.
 Silver nitrate is germicidal and helps in healing .
 Antibiotics are used as a solutions or ointments directly
against many types of bacteria.
 PSYCHOLOGY
 Explain the procedure to the patient .how much pain is
involved .this will reduce the fear and anxiety.
 Screen the patient while dressing
 Divert his mind by talking with the patient .
 Do not expose the wound in front of the patient.
 Turn his head to one side to avoid unpleasant sight.